Content and Face Validity of the Evaluation Tool of Health Information for Consumers (ETHIC): Getting Health Information Accessible to Patients and Citizens.

BACKGROUND: Health information concerns both individuals' engagement and the way services and professionals provide information to facilitate consumers' health decision making. Citizens' and patients' participation in the management of their own health is related to the availability of tools making health information accessible, thus promoting empowerment and making care more inclusive and fairer. A novel instrument was developed (Evaluation Tool of Health Information for Consumers-ETHIC) for assessing the formal quality of health information materials written in Italian language. This study reports ETHIC's content and face validity. METHODS: A convenience sample of 11 experts and 5 potential users was involved. The former were requested to evaluate relevance and exhaustiveness, the latter both readability and understandability of ETHIC. The Content Validity Index (CVI) was calculated for ETHIC's sections and items; experts and potential users' feedback were analyzed by the authors. RESULTS: All sections and most items were evaluated as relevant. A new item was introduced. Potential users provided the researchers with comments that partly confirmed ETHIC's clarity and understandability. CONCLUSIONS: Our findings strongly support the relevance of ETHIC's sections and items. An updated version of the instrument matching exhaustivity, readability, and understandability criteria was obtained, which will be assessed for further steps of the validation process.

Emergency online school learning during COVID-19 lockdown: A qualitative study of adolescents' experiences in Italy.

The COVID-19 pandemic caused abrupt and profound changes to teaching and learning. The present study seeks to understand adolescents' experiences of the emergency adoption of online school learning (OSL) during the first national lockdown in Italy. Sixty-four students in their final two years of high school were interviewed and content analysis was performed. The findings describe students' views of the changes related to OSL according to structural, individual and relational dimensions. Schools' lack of organization, overwhelming demands, as well as experience of difficulties in concentration, stress and inhibited relationships with teachers and classmates were among the challenges evidenced in the transition. OSL, however, has also made it possible to experience a new flexibility and autonomy in the organization of learning. The study stresses the importance of fostering adaptation of teacher-student relationships and collaborative learning in order to improve schools' preparedness for digital transitions in and out of emergencies.

An Integrated Model of Compliance with COVID-19 Prescriptions: Instrumental, Normative, and Affective Factors Associated with Health-Protective Behaviors.

BACKGROUND: The efficacy of public measures for reducing the transmission of the COVID-19 infection relies on citizens' voluntary adherence with prescribed actions. Drawing on prior literature about compliant behavior, this study aimed to identify factors associated with people engagement in health-protective behaviors by including a conjoint complement of instrumental/self-oriented, normative/community-based, and affective variables. METHOD: A cross-sectional study involving a non-representative sample of 4045 Italian citizens was carried out during the first stage of the pandemic (April-May 2020). Variables associated with health-protective behaviors were perceived personal and societal concerns and perceived effectiveness of the institutional response to the outbreak (instrumental dimensions), and family and friends perceived norms and sense of community responsibility (normative dimensions). Two negative emotions (anxiety and fear) were included as mediators between personal and societal concerns and outcome behaviors. RESULTS: Results showed the importance of both self-interest and community-based factors. Indeed, self-interest concerns, family perceived norms, and sense of community responsibility were significant predictors of people's decisions to engage in health-protective behaviors. CONCLUSIONS: The research findings show that compliance with public health prescriptions is a multimodal phenomenon and integrating self-interest and community-based factors can offer a better understanding of people's decision to engage in health-protective behaviors. Further, this study unveils that a shared sense of community is effective in encouraging adherence to recommended behaviors so as behavioral changes can be sustained by targeting the recommendations not only on risk minimization for oneself but also on the allocation of personal responsibility toward the belonging community.

COVID-19 in our lives: Sense of community, sense of community responsibility, and reflexivity in present concerns and perception of the future.

The aim of this study is to examine the association between citizens' perceptions of the effectiveness of the institutional response, their connection and responsibility to their community (Sense of Community-SoC; Sense of Community Responsibility-SoC-R), and their personal and social concerns about the current emergency and their perceptions of a postpandemic future during the first COVID-19 pandemic lockdown. Another variable considered was the personal reflexivity about the COVID-19 pandemic. 3925 Italian adults completed an online questionnaire during the first COVID-19 lockdown. A structural equation model with mediation was tested. Institutional effectiveness was associated with SoC, SoC-R, current social concerns, and perceptions of a postpandemic future. SoC and SoC-R were associated with current personal and social concerns, and perceptions of a postpandemic future. Reflexivity was negatively associated with SoC and positively associated with SoC-R, mediating the relationships between SoC, SoC-R and current personal and social concerns and perceptions of a postpandemic future. Findings indicate the need to adopt a perspective that considers individual and socio-political levels and their interaction to better understand the impact of the pandemic during a national lockdown.

End-tidal CO2 and transcutaneous CO2 : Are we ready to replace arterial CO2 in awake children?

INTRODUCTION: Arterial blood gas analysis (ABG) is the gold standard test for carbon dioxide measurement. End-tidal PCO2 (PetCO2 ) and transcutaneous PCO2 (PtcCO2 ) are noninvasive alternative methods. OBJECTIVE: To examine the use of PetCO2 and PtcCO2 as PaCO2 surrogates in awake children. METHODS: A prospective observational study. Consecutive awake children in a stable condition referred to the Sleep Unit of Hospital de Pediatría Dr. J. P. Garrahan with suspected or confirmed sleep-related respiratory disorders requiring ABG were included. PetCO2 and PtcCO2 were recorded simultaneously during arterial puncture. PetCO2 and PtCO2 values were compared with PaCO2 . Correlation coefficient and Bland-Altman analysis were applied. The sample size was calculated considering a mean difference ≤3 mmHg as clinically acceptable. RESULTS: Sixty-eight sample sets were obtained from 67 patients. The median age was 9.11 years (0.23-18.76). During 94.1% of the procedures patients breathed spontaneously, 30% needed multiple punctures and 92% resulted in pain. Median (IQR) PaCO2 (mmHg) was 36.3 (31.45; 40.90), PetCO2 33.0 (29; 39) and PtcCO2 38.8 (32.95; 43.32). Correlation and agreement for PaCO2 /PetCO2 and PaCO2 /PtcCO2 was r = .6 and .9, and media of bias = 2.83 (-9.97; 15.64) and -1.88 (-9.01; 5.24), respectively. Hypercapnia (PaCO2 > 45.0 mmHg) was present in 8/68 (11.8%) samples. Sensitivity, specificity, positive predictive value and negative predictive value to detect hypercapnia with PetCO2 was 38%, 98%, 75%, and 92%, respectively, and with PtcCO2 , 100%, 90%, 57%, and 100%, respectively. CONCLUSION: PtcCO2 showed better agreement with PaCO2 than PetCO2 but because of the wide dispersion of values, neither method can replace the gold standard. Transcutaneous CO2 might be a good screening tool to detect hypercapnia in awake children.

Consumo de sustancias psicoactivas en los contextos recreativos entre estudiantes universitarios en Colombia / Psychoactive Substance Consumption in Recreational Settings among University Students in Colombia / Consumo de sustâncias psicoativas nos contextos recreativos entre estudantes universitários na Colômbia

El consumo de sustancias psicoactivas (SPA) representa un problema de salud pública en Colombia y en el mundo. La población que recurre a este tipo de sustancias es cada vez más joven y sus efectos son potencialmente deletéreos y pueden afectar todas las áreas de ajuste de la persona. Aunque así se ha concebido, esta práctica no siempre está asociada con problemas personales ni con altos grados de estrés. Puede haber otras motivaciones asociadas. Objetivos: los objetivos de este artículo están dirigidos a presentar: (a) la frecuencia relativa de consumo de SPA entre los estudiantes universitarios, (b) las SPA más utilizadas por los estudiantes universitarios y sus diferencias según el sexo y la edad, (c) la relación entre el uso de SPA y los contextos de diversión. Materiales y métodos: este fue un estudio descriptivo correlacional, derivado de un proyecto de investigación italiano, con una muestra de 226 estudiantes de cuatro carreras de una universidad privada de Bogotá, seleccionados por muestreo aleatorio estratificado con asignación proporcional, a quienes se les aplicó una encuesta. Resultados: las SPA de mayor utilización son el alcohol, la nicotina y la marihuana, cuya mayor predominancia se presenta en el sexo masculino. Los resultados son congruentes con la tendencia nacional. Conclusión: el consumo de SPA en la población universitaria es alto y algunos contextos recreativos están asociados con esta conducta.

The consumption of psychoactive substances (PAS) is a public health problem in Colombia and worldwide. The people who consume such substances are becoming younger, and their effects are potentially harmful and may affect all areas of adjustment of the individual. Although it has been conceived that way, the use of PAS is not always associated with personal problems or high degrees of stress. There may be other motivations associated. Objective: The objectives of this article are to present: (a) the relative frequency of consumption of PAS among college students, (b) which are the PAS consumed most by college students and differences in their consumption by sex and by age, (3) the relationship between the consumption of PAS and contexts of diversion. Materials and methods: This is a descriptive correlational study derived from an Italian research project, in which the sample were 226 college students from four undergraduate programs of a private university in Bogotá DC, selected using a stratified random sampling procedure with proportional allocation. Participants filled out a questionnaire. Results: The PAS with the highest consumption were alcohol, nicotine and marijuana. Males predominantly showed an increased consumption. The results are consistent with the national trend. Conclusion: The consumption of SPA among college students is high and some recreational contexts are closely associated with this behaviour.

Introdução: o consumo de sustâncias psicoativas (SPA) representa um problema de saúde pública na Colômbia e no mundo. A população que recorre a este tipo de sustâncias é cada vez mais jovem e seus efeitos são potencialmente deletérios e podem afetar todas as áreas de ajuste da pessoa. Mesmo que assim tenha se concebido, esta prática não sempre esta associada com problemas pessoais nem com altos graus de estresse; pode ter outras motivações associadas. Objetivos: os objetivos deste artigo estão dirigidos a apresentar: (a) a frequência relativa de consumo de SPA entre os estudantes universitários, (b) as SPA mais utilizadas pelos estudantes universitários e suas diferenças segundo gênero e a idade, (c) a relação entre o uso de SPA e os contextos de diversão. Materiais e métodos: este foi um estudo descritivo correlacional, derivado de um projeto de pesquisa italiano, com uma amostra de 226 estudantes de quatro cursos de uma universidade privada de Bogotá, selecionados por amostragem aleatória estratificado com designação proporcional. Resultados: as SPA de maior utilização são o álcool, a nicotina y a maconha, cuja maior predominância se apresenta no gênero masculino. Os resultados são congruentes com a tendência nacional. Conclusões: o consumo de SPA na população universitária é alto e alguns contextos recreativos estão associados com esta conduta.